Neobladder procedure offers alternative to those with bladder cancer

Treatments for patients with bladder cancer can bring drastic changes, but one procedure is trying to offer a better solution.

Thursday, August 21, 2014

Bladder cancer affects 75,000 people in this country every year, but treating it can bring drastic change to patients. So now, Bay Area surgeons are offering a new option -- the neobladder procedure.

After a long drive, Sheldon Querido of Thousand Oaks does something most of us do after sitting in traffic, he heads to the restroom.

"I can be normal and live a normal life," Querido said.

Four years ago, he was diagnosed with bladder cancer and was told the only way to cure it was to remove his bladder.

"My first response was, I don't want to live like that. That's going to be a terrible way to live," Querido said.

Without a bladder, he would have to have a colostomy, a surgical opening in his abdomen with an external bag. While many people learn to adjust to it, Querido wanted another option.

Dr. Kevin Chan from the City of Hope Medical Center, proposed creating something called a neobladder. It would recreate the bladder using parts of Querido's small intestine.

"The new bladder that we make out of the small intestine uses about two feet of the intestine. We reconfigure it into a kind of a spherical shape. We hook the kidneys in and hook it right back up to the urethra," Chan said.

The procedure comes with a high complication risk that can include infections, blockages and follow-up surgeries. And Chan says it can mean a longer recovery. But for patients who are candidates, he believes in the benefits.

Chan said they look at "these guys as likely to be cured. We've got to make sure they're going to be able to do those things they were doing before surgery." About 60-90 percent of patients who need to get their bladder removed will end up needing a bag. Doctors say that number could be cut dramatically by the new procedure.

"I've had patients refuse surgery because they think they're going to have a bag. They're not even necessarily offered the neobladder or they don't know that it exists," Chan said.

Querido wants other patients to know there are options. He said, "It needs to be told to the public, how life affirming this surgery really is."

Several factors are taken into consideration when doctors screen patients for the neobladder surgery including kidney function, the extent of the cancer, and previous radiation treatments, which could affect the way you heal.